Service Address	Billing Address (if different from Service Address)
Name Address	Name Address
City Zip	City Zip
Home # Work # Cell # Email	Home # Work #
LAWN CARE	TREE CARE
1. Gold Package   Silver Package   Bronze Package   Other/Specific Application Explain: 2. Aeration   Sub Surface Insecticide   Surface Insecticide   Perimeter Pest Control   Mosquitoes Spraying   Dormant Treatment   Dethatch and Haul   Other Explain: 3. *Seasonal services in sction #3 require a written contract: which will be promptly submitted. Any job over $500 requires a 30% deposit.*   Seasonal Lawn Cutting*   Spring Clean-Up*   Fall Clean-Up*	4. Emerald Ash Bore Prevention   Dormant Oil   Spring Deep Root Feeding   Spring Deep Root Feeding of Special Mix with Systemic Insecticide and Vitamins   Spring Insect & Disease Control   Late Summer Insect, Disease & Mite Control   Summer Insect, Disease & Mite Control   Fall Deep Root Feeding   Fall Deep Root Feeding of Special Mix with Systemic Insectice and Vitamins   Mauget Injections, per Estimate   Pruning and Removal     (Please submit contract,if required)   Other Explain:
OPTIONS (CHECK ALL THAT APPLY)	SIGNATURE
5. I would like to be billed per visit.   Renewing customer   Yes, we have an in ground pool with grass in pool area.   Please don't service our lawn on Saturday's   Please call prior to each treatment.* *Please note there is a one-time $12.00 administrative Fee.	Customer E-Signature Date
Yes, we have an underground sprinkler system.*   Yes, we have an invisible dog fence.   Yes, we have underground cables/wires less than 4" from the surface.	If you are signing up for an aeration and have checked either of these boxes, we will need areas marked prior to aeration. Turf and Tree Worx will not be responsible for damage to under-ground sprinkler systems, cables and/or wires, dog fences, etc. marked or not marked. (Customer assumes liability.)